REVIEWS

In The Ethics of Need: Agency, Dignity, and Obligation, Sarah Clark Miller presents a thoughtful synthesis of feminist care ethics and Kantian moral philosophy. As Miller is well aware, these two schools of thought are not obvious philosophical partners. Built on the psychological research of Carol Gilligan from the 1970s, care ethics has sought to redirect philosophical attention to the particular, the contextual, and the emotional. In addition, some care ethicists have claimed that this ethical terrain is feminine rather than masculine, and has been historically neglected for sexist reasons. Kant himself is often held up as one of the classically abstract and rationalistic philosophers against whom care ethics defines itself. Miller seeks to challenge this picture of Kant with a reading and adaptation of his moral theory. At the same time, she attempts to correct for a gap she perceives in care ethics: that it cannot explain why human beings have a moral obligation, as opposed to sometimes simply an emotional tendency, to care for others.

The centerpiece of this synthesis is, first of all, Miller's concept of fundamental human needs. Miller begins her treatment by analyzing needs claims, "X needs Y to Z" (32). We may be dealing with fundamental needs when the Z term drops out, as in "John needs food." Miller then interprets fundamental needs in terms of agency: these needs, she says, are what human beings require to avoid the harm of compromised agency. Miller emphasizes that the notion of agency she has in mind goes beyond the traditional philosophical interpretation of agency as purely rational agency. Drawing on a background of feminist scholarship from the last decade, she puts forth a conception of agency that includes emotional and relational competencies, and that exists on a continuum. She concludes her introduction to needs with a list of fundamental needs that encompasses eleven different categories (41–42). Miller underscores that her list, though unapologetically objective, is open to revision and local interpretation.

Building on the account of needs, Miller then argues for a "duty to care" (45), which she explicates further as the duty to meet the fundamental needs of others, or, given the previous account of fundamental needs, to support their agency. Here she turns to Kant in earnest. She argues that an account of the duty to care can be built on Kant's duty of beneficence, which is characterized in the Metaphysics of Morals and is given a deeper justification in the Groundwork. In the former work, the duty of beneficence is explained as a wide duty to the take up the ends of others as one's own by meeting their true needs (Kant 1996 6:452–53; 6:393). Kant characterizes the duty as wide because we are not compelled to meet the needs of any particular others, but to use our moral judgment in deciding whose needs to meet (6:390). Next, in the Groundwork, Kant justifies the duty of beneficence with one of his famous thought experiments. According to Kant, we have a duty of beneficence because we would not want to live in a world in which no one came to the aid of others (Kant 1993, 423). Miller endorses the reasoning behind the thought experiment as she interprets it, concluding that "it is in light of their finitude, vulnerability, and interdependence that human beings have a duty to care for one another" (56).

Miller makes sure to keep track for the reader of the ways in which her account parts company with Kant's. First she points out that, given her more inclusive sense of agency, her notion of fundamental needs is more expansive than Kant's notion of true needs. Second, she says that although feminist care ethics can remain true to itself while borrowing the "scope" and the "ground" of the duty to care from Kantian moral philosophy, it must turn elsewhere for the "content" or "manner of meeting needs" (72). Here earlier contributions to the ethics of care can help to fill in the blanks. Drawing on this literature, Miller discusses features of good care at length, arguing that it is care emotionally attuned to the one receiving care; that it is conscious of power relations; and that it is sensitive to the shame that can accompany dependency. Miller argues that attempts to meet others' needs that do not fit this profile can, paradoxically, erode their agency. Second, such attempts, even if they do not seriously damage agency, cannot count as "dignifying care" (88). To develop this latter concept, Miller first outlines Kant's concept of dignity, the worth possessed by moral agents in virtue of their rational capacity to set their own ends. She points out that human beings in fact have a second moral capacity, the capacity to care for others, that is, to take up and promote the ends of others by meeting their needs. She suggests that, just as Kant thinks we are owed respectful and nonexploitative treatment in virtue of our capacity for rationality, so too we are owed dignifying care in virtue of our capacity for care. This amendment of Kantian moral philosophy is reminiscent of Eva Kittay's engagement with John Rawls's political philosophy. In Love's Labor: Essays on Women, Equality, and Dependency, Kittay suggests that Rawls's conception of the person should be altered to include a capacity for care (Kittay 1999, 101–02). Since Rawls is influenced by Kant, and Miller by Kittay, the convergence here is natural enough.

The basic elements of Miller's Kantian ethics of care are consistent and carefully thought through. But her framework's value ultimately depends on its ability to capture care ethics' best insights and to plausibly resolve practical conflicts associated with care. Here Miller's framework is successful in some respects, less so in others. First, Kant's insights admirably answer the question "Ought I to care?" with a resounding yes, and thus explain why we should care for others even when temporarily we "don't feel like it." Next, at least since Kittay's work, feminist scholarship on care has sought to focus on the needs of the caregiver as well as her charge, and to show how the two can be brought into balance. As Miller points out, Kant posits duties to self as well as others, which explains why we should not allow caretaking activities to destroy us (62–63). A third challenge is to explain why the meeting of needs should respect the agency of those receiving care. Since, on Miller's Kantian account, need is defined in terms of agency, the ability for care to come into conflict with agency is limited from the start.

However, Miller's framework is less successful in explaining which possible caregiving relationships should take moral priority. Here her case studies, which occupy the second half of the book, illustrate the limitations of the framework. In chapter 4, "The Margins of Agency," she addresses the obligations adult children have to their aged parents. She reviews other grounds given for the obligation in the philosophical literature, including gratitude for past care and friendship. She rejects these grounds as inadequate, saying that the following answer is preferable: "Adult children must care for their aging parents because of the web of vulnerability and interdependence in which they are intertwined, as well as because of the particular relation in which they stand to their parents" (104). Although this answer harmonizes with the work of non-Kantian care ethics, it does not necessarily mesh with the Kantian account Miller has previously given. The duty of beneficence permits us to direct care in accordance with moral judgment and sentiment, but does not establish a special obligation to aged parents. Do we have obligations to ill parents who have disappeared from our life for a decade or more, but who now need us? Should we give preference to biological family when we have friends who mean more to us? Since Miller assumes that sometimes we ought to care even in the absence of warm feelings, these questions should be relevant for her account. Yet her treatment does not broach them, beyond suggesting that children may not have obligations to parents who were outright abusive.

Similarly, her final chapter on cosmopolitan care leaves unanswered some of the stickiest questions about duties to distant others. She rightly notes that conceiving of our obligations to foreigners as duties of care can explain why we should be sensitive to local conditions and structures of oppression when giving aid. However, when she addresses the possibilities of these obligations competing with others, she focuses on the way the duty to self limits our obligations to extend global care at the expense of our individual well-being. But, beyond urging the use of moral judgment, Miller does not untangle the most pressing concern of debates on cosmopolitanism: how to adjudicate between the needs of compatriots and those living outside that community.

Thus the Kantian approach to the ethics of care can capture and strengthen some of the intuitions that have characterized that approach. Miller's account provides a strong theoretical basis for explaining the importance of supporting agency in meeting needs, the dangers of paternalism, and our obligations to meet the needs of caregivers. Although the Kantian approach can be accused of downplaying emotion, it also has the strength of not demanding a constant outflow of sentiment from caregivers. This latter demand has been made as often as not by sexist theorists who assume that women, however taxed their resources, are naturally predisposed to self-sacrifice. On the other hand, as we have seen, grounding the duty to care in the duty of beneficence does not explain how to adjudicate among obligations to biological family, friends, compatriots, and distant others.

Margaret Meek Lange received her PhD in political theory from Columbia University. Her research is on liberal political theory and its critics. She is concerned to develop and defend conceptions of autonomy and of liberal institutions that can learn from and address feminist, communitarian, and environmentalist criticisms of liberalism. Right now she is working with Catriona Mackenzie, Wendy Rogers, and Susan Dodds on an Australian Research Council Discovery Project on Autonomy, Vulnerability, and Justice. margaret.meek@gmail.com

"The basic elements of Miller's Kantian ethics of care are consistent and carefully thought through. But her framework's value ultimately depends on its ability to capture care ethics' best insights and to plausibly resolve practical conflicts associated with care."